[The Grice technique for tarsal coalition]. / Coalición tarsal, técnica de Grice.

OBJECTIVE: Show that the surgical release of the coalition area and the Grice subtalar arthrodesis are useful for the treatment of tarsal coalition, and describe the surgical techniques used. MATERIAL AND METHODS: This is a prospective, longitudinal, non-randomized clinical trial conducted from January 2001 to December 2007. Patients of both genders were selected, ages 10-15 years of age, with a diagnosis of tarsal coalition without any other type of orthopedic or neurologic comorbid condition. The Harris classification of tarsal coalition was used. AP, lateral and oblique X-rays of both feet were ordered, as well as a CAT scan; the Costa-Bertani angles were measured. Central trend and scatter measurements were performed for the statistical analysis, as well as the comparison of means Z test, the relative risk (RR) and the linear correlation. RESULTS: Twenty-six patients, 20 males and 6 females, were included in the study; 12 of them had fibrous talocalcaneal coalitions, 12 had bone coalitions and 2 had calcaneonavicular coalitions. COMPLICATIONS: one reflex sympathetic dystrophy, 4 superficial infections, 4 graft resorptions, and 4 patients with persistent pain. In the Z test for the Costa-Bertani angles the p value was 0.0020. The RR for obesity was 4.5, the linear correlation coefficient r for valgus hindfoot and pain was 78. DISCUSSION: The clinical results indicate an improvement in pain and gait. Overweight was found to be a risk factor for persistent pain.

[Radiological evaluation of the flexibles pes planus treated with conic endorthesis]. / Valoración radiológica del pie plano flexible tratado con endoprótesis cónica.

OBJECTIVE: To determine the correction of flexible pes planus by means of the placement of a conic endorthesis in the subtalar joint. Outcomes were based on measures of the Moreau-Costa-Bartani and talar-navicular angles. MATERIAL AND METHODS: A series of 22 patients of both genders (7 to 13 years-old), were operated on both feet. The subtalar joint was stabilized by placement of a conic endorthesis. All of them were diagnosed as flexible pes planus, and 44 feet were operated on. All cases had previous conservative treatment without improvement. In these patients the Moreau-Costa-Bartani and talar-navicular angles were measured on lateral and dorsoplantar projections respectively, and compared pre and post-operatively. RESULTS: Significant correction of the analyzed angles was achieved. We obtained less than 130 p in the "A" angle and less than 150 p in the "B" in the lateral projection, and less than 80 p in the dorsoplantar projection. CONCLUSION: Normal Moreau-Costa-Bartani and talarnavicular angles were achieved by means of the subtalar placement of a conic endortheses, and normal ranges were obtained in the simple X-rays measures.

[Voluntary dislocation of the hip. Report of two cases]. / Luxación voluntaria de cadera. Reporte de 2 casos.

CASE REPORTS: Case 1: We present a 5 year-old female patient with ligament laxity who started on August 1992 at 4 years of age when doing voluntary medial rotation and adduction of the hip, she presents with a posterior dislocation of the hip joint and voluntary reduction, with no more clinical data. Later on she realizes voluntary dislocation of the hip from three to five times a week, without pain or any clinical findings. She was evaluated by the Genetics Department who isn't able to integrate a syndrome. X-ray findings on the AP view show a right hip with a posterior dislocation, and a normal left hip. Case 2: We present a 7 year-old male patient who started on August 2001 when he suffered a fall from his own height over his right side, and presented an asymptomatic anterior dislocation of the right hip. From this moment on he presented multiple events of involuntary dislocation of the right hip. X-ray findings on the AP view show an anterior dislocation of the right hip. A Ponseti cast was used over night and the patients were educated to not dislocate the hip. They received yearly follow up until August 2004, with no more dislocations of the hip joint. The conservative treatment plan was effective as a definite treatment.